Last week the AMA published information about several important coding and billing updates that will affect claims submission, and compliance in your practice and ASC.

Unexpected October 1^st  Effective Date

The effective date for the several new category III codes, including the following codes for ophthalmic procedures, has been moved up to October 1, 2026. This is a deviation from the usual policy for new or revised to take effect on January 1^st.

1080T    Insertion, intracapsular magnifier, with attachment to previously placed intraocular lens

1084T   Implantation of scaffolding allograft to reinforce the suprachoroidal space

+1090T (Add-on code) Attachment and insertion of intraocular lens prosthesis-mounted          

drug-eluding implant (list separately in addition to code for primary procedure)   

(Use 1090T in conjunction with 66982, 66983, 66984, 6698, 66986, 66987, 66988, 66989, 66991)

 

1098T  Placement of subretinal prosthesis, including vitrectomy

(Do not report 1098T in conjunction with 67036, 67030, 67040, 67041, 67042, 67043, 0100T)

(For placement of retinal prosthesis, use 0100T)

These category III codes were released to the AMA website on July 1, 2026 and will be in the published CPT book January 1, 2027.

The complete list of affected codes can be found on the AMA’s website  CPT Category III Codes This early implementation means practices may begin using the new codes ahead of the traditional January 1 CPT cycle. Early adoption may help to streamline reporting to a single code for all payers.

Normal October 1^st Implementation

Each year, the 2027 ICD-10-CM code set scheduled for its standard annual implementation on October 1. As always, this update will include new, revised, and deleted diagnosis codes. Teams should plan for the usual payer readiness checks, EMR updates, and staff training to ensure a smooth transition.

Normal January 1^st Implementation

Finally, the annual January 1 implementation of the new, revised, and deleted CPT codes for the upcoming year is unchanged. Consider beginning your preparation of system updates, template adjustments, and coding education to stay compliant and avoid claim delays.

We will continue to share updates as more information becomes available. Please circulate this notice to your billing, coding, and clinical documentation teams so they can prepare accordingly. Of course, if questions arise, do not hesitate to contact us at (800) 399-6565,  email us at consultants@corcoranccg.com.